Hemorrhage in Onodi Cell Leading to Traumatic Optic Neuropathy

Traumatic optic neuropathy (TON) is an important cause of vision loss in the setting of cranial and/or facial trauma. Both direct and indirect variants exist, with the latter being more common. We describe the case of a young male presenting with loss of vision following trauma with an intact globe, an intraorbital foreign body, and Onodi cell hemorrhage. The challenges in diagnoses of type of TON, exact pathology, and management are discussed. We also highlight the role of thin section digital computed tomography imaging which is paramount for timely detection of subtle injuries and their management.